天疱疮患者96例预后分析  

Prognostic Analysis of 96 Patients with Pemphigus

作　　者：张广贺 张立明[1] 徐宏慧[1] 夏立新[1] 高兴华[1] 肖汀[1] ZHANG Guanghe;ZHANG Liming;XU Honghui;XIA Lixin;GAO Xinghua;XIAO Ting(Department of Dermatology,the First Hospital of China Medical University,Key Laboratory of Immunodermatology of Ministry of Education,National Health Commission Key Laboratory of Immunodermatology,National Joint Engineering Research Center for Theranostics of Immunological Skin Diseases,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院皮肤科,教育部免疫皮肤病学重点实验室,卫健委免疫皮肤病学重点实验室,免疫性皮肤病诊疗技术国家地方联合工程研究中心,辽宁沈阳110001

出　　处：《中国皮肤性病学杂志》2023年第8期911-916,共6页The Chinese Journal of Dermatovenereology

摘　　要：目的 探索影响天疱疮患者预后的因素。方法 回顾性收集本科2015—2021年住院天疱疮患者的临床资料,用Kaplan-Meier法和Log-rank时序检验进行单因素生存分析,Cox逐步回归模型进行多因素生存分析。陈旧皮损消退的前提下,无新发皮损至少两个月定义为完全缓解,仍系统应用泼尼松≤10 mg/d和/或最小剂量免疫抑制剂治疗定义为用药完全缓解,停止所有系统药物治疗定义为停药完全缓解。结果 共纳入96例天疱疮患者,寻常型67例,落叶型29例。平均随访时间(38.55±22.10)个月。寻常型天疱疮患者中29例(43.28%)达到用药完全缓解,8例(11.94%)达到停药完全缓解;落叶型天疱疮患者中13例(44.83%)达到用药完全缓解,10例(34.48%)达到停药完全缓解。单因素分析显示,寻常型天疱疮患者停药完全缓解时间的不利影响因素为发病年龄≥50岁(P=0.034);落叶型天疱疮患者停药完全缓解时间的不利影响因素为入院时病程≤6个月(P=0.021)。多因素分析显示,寻常型天疱疮(HR=0.257,95%CI:0.096~0.688,P=0.007)和入院时病程≤6个月(HR=0.287,95%CI:0.109~0.756,P=0.012)与停药完全缓解时间呈负相关。结论 发病年龄≥50岁和病程≤6个月分别为寻常型天疱疮和落叶型天疱疮达到停药完全缓解的不利因素。寻常型天疱疮比落叶型天疱疮更难达到停药完全缓解。Objective To explore factors affecting prognosis of pemphigus patients.Methods The clinical data of inpatients with pemphigus vulgaris(PV) and pemphigus foliaceus(PF) in our department from 2015 to 2021 were retrospectively analyzed.The Kaplan-Meier method and Log-rank test was used for survival univariate analysis.The Cox stepwise regression model was used for multivariate analysis.Absence of new or established lesions,while receiving prednisone ≤10 mg/day and/or minimal adjuvant therapy,or off all systemic therapy,for at least 2 months,were defined as complete remission(CR) on therapy(CRonT) and CR off therapy(CRoffT),respectively.Results A total of 96 patients with pemphigus were enrolled,including 67 patients with PV and 29 patients with PF.For a mean period of(38.55±22.10) months,29(43.28%) and 8(11.94%) patients with PV reached CRonT and CRoffT,13(44.83%) and 10(34.48%) patients with PF reached CRonT and CRoffT,respectively.Univariate analysis showed that the adverse factors for CRoffT were age of onset ≥50 years(P=0.034) and disease duration ≤6 months(P=0.021) in patients with PV and PF,respectively.Cox regression analysis showed that PV subtype(HR=0.257,95%CI:0.096-0.688,P=0.007) and disease duration ≤6 months(HR=0.287,95%CI:0.109-0.756,P=0.012) were negatively correlated with CRoffT.Conclusion The age of onset ≥ 50 years and the disease duration ≤ 6 months are adverse factors of reaching CRoffT in patients with PV and PF,respectively.Patients with PV are more difficult to reach CRoffT than patients with PF.

关 键 词：寻常型天疱疮 落叶型天疱疮 缓解 预后 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]